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Epidemiology of Concussions in High School Boys' Ice Hockey, 2008/09 to 2016/17 School Years

Kerr, Zachary Y., PhD, MPH*; Pierpoint, Lauren A., MS; Rosene, John M., DPE

doi: 10.1097/JSM.0000000000000697
Original Research: PDF Only

Objective: This study examined the epidemiology of concussions in high school boys' ice hockey during the 2008/09 to 2016/17 school years.

Design: Prospective cohort study. Athletic trainers from an average 33 high schools annually reported boys' ice hockey concussion and athlete-exposure (AE) data for the High School Reporting Information Online system.

Setting: Convenience sample of high school boys' ice hockey programs during the 2008/09 to 2016/17 school years.

Patients or Other Participants: High school boys' ice hockey players (aged ∼14-18 years).

Independent Variables: Concussion data on event type, injury mechanism, symptom resolution time, and time loss were obtained.

Main Outcome Measures: Concussion rates with 95% confidence intervals (CIs) and distributions were calculated.

Results: Overall, 348 concussions were reported in boys' ice hockey during the 2008/09 to 2016/17 academic years, leading to a concussion rate of 0.68/1000 AEs (95% CI, 0.61-0.75). Most occurred in competitions (85.6%), particularly after the first period (72.1% of all competition concussions). Among practice concussions, most occurred after the first hour of practice (60.0%). Most concussions were due to player contact (47.7%) and boards/glass contact (31.9%). Although 69.0% of concussed athletes had symptoms resolve in less than 7 days, only 14.1% returned to activity within a week.

Conclusions: Most concussions occurred within the second and third periods. Preventive strategies that counter an increased risk of concussion due to a greater intensity of gameplay coupled with increased fatigue may be warranted. Moreover, athletes may further benefit from prevention efforts that focus on anticipating impacts during gameplay.

*Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina;

Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado; and

Department of Exercise and Sport Performance, University of New England, Biddeford, Maine.

Corresponding Author: Zachary Y. Kerr, PhD, MPH, Department of Exercise and Sport Science, University of North Carolina, 313 Woollen Gym, CB#8700, Chapel Hill, NC 27599-8700 (

The authors report no conflicts of interest.

The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control and Prevention or any of the other institutions that provided financial support for this research.

Received March 06, 2018

Accepted October 13, 2018

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